Depression, Anxiety and Post-traumatic Growth Among Bereaved Adults: A Latent Class Analysis

Abstract

BackgroundThe death of a loved one can trigger a range of responses, including painful thoughts and emotions, as well as positive changes, such as post-traumatic growth (PTG). To understand more about the relationship between these outcomes this study explored the co-occurrence of depression, anxiety and PTG among a group of bereaved Chinese adults.MethodsData were collected from 194 participants, who had lost a first-degree relative. Latent class analysis was used to analyze the data to identify subgroups of participants with shared symptom profiles.ResultsThree classes were identified: a Growth class, a Depression/Anxiety/Growth class and a Depression/Anxiety class. Marital status, social support, close relationship with the deceased and witnessing the suffering of the deceased were identified as differential predictors of class membership.ConclusionThe findings contribute to our understanding of the potentially wide ranging impacts of bereavement and highlight the important role of stressor characteristics and support and in influencing impairment and positive outcomes.

Profiles of grief, post-traumatic stress, and post-traumatic growth among people bereaved due to COVID-19

“…In the present study, four profiles of prolonged grief, post-traumatic stress and post-traumatic growth were identified among the 422 Chinese people bereaved due to COVID-19 after one to nine months of the death: the resilience group (10.7%) with low PGD, PTSD and PTG scores; the growth group (20.1%) with low PGD and PTSD but high PTG; the moderate-combined group (42.2%) with moderate scores across all scales; and the high-combined group (27.0%). These patterns, especially the growth group with high PTG and low emotional disorders, echo the findings from previous studies among the general bereaved Chinese and those who lost their only child (Li et al, 2020;Zhou et al, 2018). The smaller growth group in the present study (20.1% vs. 40% and 64.4%) could be partially attributed to the differences in observed variables.…”

“…The smaller growth group in the present study (20.1% vs. 40% and 64.4%) could be partially attributed to the differences in observed variables. In the study by Li et al (2020), indicators of negative bereavement outcomes are less prominent ones like depression and anxiety rather than pathological grief, which could lead to the underestimation of maladaptive subgroups. Moreover, the COVID-19 context could make growth after bereavement harder.…”

“…Both studies unveiled an encouraging subgroup that experiences bearable pains and achieves drastic gains after major losses in life. In a study by Li, Sun, Maccallum, and Chow (2020), 194 general bereaved Chinese reported their anxiety, depression and PTG, and a growth group with high PTG and low anxiety/depression accounted for 64.4% of the sample.…”

“…In the aforementioned studies, losing a child or spouse rather than others (Eisma et al, 2019;Li et al, 2020;Zhou et al, 2018), high attachment anxiety and attachment avoidance (Maccallum & Bryant, 2018a), lower social support (Li et al, 2020), sense of unrealness (Lenferink et al, 2017), negative cognitions about one's grief (Djelantik et al, 2017) and negative self-related appraisals (Maccallum & Bryant, 2018a) were unveiled by multinomial logistic regressions as significant predictors of maladaptive classes. One disadvantage of multinomial logistic regression is that misclassification of cases in the preceding LVMM is neglected when testing the predicting effects of covariates (Asparouhov & Muthén, 2014).…”

Changes in depressive symptoms among family caregivers of patients with cancer after bereavement and their association with resilience: A prospective cohort study

“…Thus, resilience might act protectively against distress and promote recovery but might not necessarily promote growth. This finding is consistent with the reports wherein PTG showed a curvilinear relationship with CG 38 and depression 39 . However, considering the small sample size of our study, further research is needed.…”